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Effects of maternal vitamin A status on kidney development: a pilot study

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Abstract

Nephron endowment ranges widely in normal human populations. Recent autopsy studies have drawn attention to the possibility that subtle congenital nephron deficits may be associated with increased risk of developing hypertension later in life. Since modest maternal vitamin A deficiency reduces nephron number in rats, we designed a pilot study to determine the prevalence of maternal vitamin A deficiency in Montreal (Canada) and Bangalore (India) and the usefulness of newborn renal volume as a surrogate for nephron endowment. Among 48 pregnant Montreal women, two (4%) had one isolated mid-gestation retinol level slightly below the accepted limit of normal (0.9 μmol/L), whereas 25 (55%) of 46 pregnant women in Bangalore had at least one sample below this limit. Average estimated retinoid intake was correlated with mean serum retinol in pregnant women from Bangalore. In Montreal where maternal vitamin A deficiency was negligible, we found that newborn renal volume (estimated by renal ultrasonography at 2–6 weeks of age) was correlated with surface area at birth and was inversely correlated with serum creatinine at 1 month. Interestingly, renal volume adjusted for body surface area in Montreal (184±44 ml/m2) was significantly greater than in Bangalore (114±33 ml/m2) (p<0.01). Definitive studies are needed to establish whether maternal vitamin A deficiency accounts for subtle renal hypoplasia in Indian newborns. If so, there may be important public health implications for regions of the world where maternal vitamin A deficiency is prevalent.

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Acknowledgements

This study was supported by a grant from the McGill University Health Centre Research Institute. Paul Goodyer is the recipient of a Canadian Institutes of Health Research (James McGill) Chair.

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Authors and Affiliations

  1. Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada

    Paul Goodyer, Diane Laforte & Chandhana Raju

  2. Division of Nutrition, Institute for Population Health and Clinical Research, Saint John’s Academy of Health Sciences, Bangalore, India

    Anura Kurpad, Sumitra Muthayya & Pratibha Dwarkanath

  3. Departments of Pediatrics, Kidney Care Center, St. John’s Medical College Hospital, Bangalore, 560034, India

    Swarna Rekha & Arpana Iyengar

  4. Department of Radiology, St. John’s Medical College Hospital, Bangalore, 560034, India

    Babu Philip

  5. Department of Obstetrics, St. John’s Medical College Hospital, Bangalore, 560034, India

    Arun Mhaskar

  6. Department of Obstetrics, McGill University Health Centre, Montreal, Quebec, Canada

    Alice Benjamin & Suran Maharaj

  7. Children’s Kidney Care Center, St. John’s Medical College Hospital, Sarjapur Road, Bangalore, 560034, India

    Kishore Phadke

  8. Department of Pediatrics, St. John’s Academy of Health Sciences, Bangalore, India

    Kishore Phadke

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  1. Paul Goodyer
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  2. Anura Kurpad
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  3. Swarna Rekha
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  4. Sumitra Muthayya
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  7. Babu Philip
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  8. Arun Mhaskar
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  9. Alice Benjamin
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  10. Suran Maharaj
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  11. Diane Laforte
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  12. Chandhana Raju
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  13. Kishore Phadke
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Correspondence to Kishore Phadke.

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Goodyer, P., Kurpad, A., Rekha, S. et al. Effects of maternal vitamin A status on kidney development: a pilot study. Pediatr Nephrol 22, 209–214 (2007). https://doi.org/10.1007/s00467-006-0213-4

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  • DOI: https://doi.org/10.1007/s00467-006-0213-4

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